Lisa Foster England said the tough decisions she?s made could save both her and her children?s lives.

England teaches at the Middle Fork Elementary school and said that moments such as singing with her students keeps her going during her ongoing 19-year battle with stage four stomach cancer.

She was diagnosed with the disease in 1991 at age 32.

"The path report was so bad that my chances were very bad that I wasn't even going to survive," England said.

To save her life, doctors removed 82 percent of her stomach. Her weight dropped to an alarming 71 pounds.

"Many times I wanted to give up, wanted to say, ?This is it Lord, take me, I'm done,?" England said.

But she didn?t give up and she said that her three children kept her going.

"I really far exceeded anything they ever expected for me, my prognosis was so bad even my surgeon said, ?She won't see her children become adults,?" England said.

But for the next 15 years England survived and thrived

?I managed to go back to school, get my master's degree. All my doctors had made me like the stomach cancer poster child -- so I was beginning to believe that, to hold that in my heart, that maybe I have made it," England said.

Then in 2006 the cancer came back. Doctors discovered it was actually something rare called hereditary diffuse gastric cancer -- that meant removing the rest of her stomach

"Jeff said, ?What kind of quality of life is she going to have with no stomach?? He said, ?She's made it 15 years with 14 percent, I think she'll find a way to be normal,?" England said.

Doctors were able to make a bypass of sorts with 10 inches of her small intestine. It makes it possible for her to eat.

England said she?s worried for her daughter because the girl tested positive for the gene mutation that causes the disease.

"Having a CDH-1 gene is scary because the only prevention is to get that stomach out," England said.

Her daughter will be having that done soon, in the meantime, England is reminding her that life will go on

"I?m not on disability. I still do everything I did before. I?m very active, it takes an adjustment but I don't want anyone to think that even a cancer diagnosis is it.. You can't just lie down and die," England said.

Unfortunately, her battle isn?t over yet. Because she has the gene for stomach cancer, doctors said England is at an extremely high risk of developing breast cancer.